Denise B. Webb State Health IT Coordinator May 9, 2013

Protecting and promoting the health and safety of the people of Wisconsin 2 1.Background Information 2.Program Requirements 3.Value of Certified EHR Technology 4.Strategies for Adopting Certified EHR Technology 5.Next Steps & Resources

 2009 American Recovery and Reinvestment Act (ARRA) HITECH Act $25.9B appropriated for health IT Regulation Protecting and promoting the health and safety of the people of Wisconsin 3

Launched in 2011 and runs through 2021 Is NOT a mandatory program for Medicaid providers Provides payment to providers as they Adopt, Implement, or Upgrade (AIU) or Meaningfully Use Certified EHR Technology (CEHRT) Medicaid EHR Incentive Program. Payment Year Payment Amount (30% Patient Volume) Reduced Payment Amount for Pediatrician’s 20% Patient Volume Year 1$21,250$14,167 Year 2$8,500$5,667 Year 3$8,500$5,667 Year 4$8,500$5,667 Year 5$8,500$5,667 Year 6$8,500$5,667 Total$63,750$42,500 Protecting and promoting the health and safety of the people of Wisconsin 4

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Eligibility 6 Medicaid Provider Types: Physician, Dentist, Certified Nurse Midwife, Advanced Practice Nurse Prescriber, Nurse Practitioner, and certain Physician Assistants Not hospital based Meet patient volume thresholds 30%, except pediatricians (20%)

7 Protecting and promoting the health and safety of the people of Wisconsin Calculating Patient Volume In order to be eligible to receive payments, Eligible Professionals must meet patient volume requirements. Eligible Professionals can meet the requirement through three different calculation options. ▶ Needy Individual Patient Volume ▶ Medicaid Patient Volume ▶ Group/Clinic Patient Volume A standard deduction will be applied to Patient Volumes using Medicaid Encounters

 Adopt ◦ Acquired or installed  Implement ◦ Commenced use  Upgrade ◦ Expansion of the functionality 1st Payment YearEligible Professional 2nd – 6th Payment Year Adopt, Implement, or Upgrade Certified EHR Technology or demonstrate meaningful use of certified EHR technology ◦ Demonstrate Meaningful Use of certified EHR technology ◦ EHR Reporting Period ◦ 90 consecutive days within the Program Year for 1st year of demonstrating MU ◦ 1 year for subsequent years of demonstrating MU ◦ In 2014 – 90 consecutive days within the Program Year for all EPs Certified EHR Technology – Adopt, Implement, or Upgrade Protecting and promoting the health and safety of the people of Wisconsin 8

1st Payment YearEligible Professional 2nd – 6th Payment Year Adopt, Implement, or Upgrade certified EHR technology or demonstrate meaningful use of certified EHR technology ◦ Demonstrate Meaningful Use of certified EHR technology ◦ EHR Reporting Period ◦ 90 consecutive days within the Program Year for 1st year of demonstrating MU ◦ 1 year for subsequent years of demonstrating MU ◦ In 2014 – 90 consecutive days within the Program Year for all EPs Certified EHR Technology – Meaningful Use (MU) Three Stages of Meaningful Use: A Graduated Approach  Stage 1 – Capture and share data  Stage 2 – Advanced Clinical Processes  Stage 3 – Improved Outcomes Protecting and promoting the health and safety of the people of Wisconsin 9

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Benefits for Medical Practices and Patients 11 Protecting and promoting the health and safety of the people of Wisconsin Reduce Healthcare Costs Improve Operational Efficiency Increase Healthcare Quality An EHR in your county department may enable providers to… Enhance care coordination Help reduce duplicate testing and delays Reduce health disparities among different populations Increase access to affordable care Enhance patient safety by reducing errors Access accurate and complete information about patient’s health Diagnose medical health problems sooner Better informed clinical decisions Prescribe more safely and reliably Measure quality of care and population health through reports and graphs Improve clarity of data entered Share data with other healthcare providers using state HIEs and the Nationwide Health Information Network, i.e. eHealth Exchange Reduce missing medical charts Remotely access electronic medical records Allow simultaneous access to patient charts by multiple users Interface with labs, registries, other EHRs, and Health Information Exchanges (HIEs ) Reduce paperwork and paperwork storage costs Eliminate the cost of chart supplies Increase interoperability with others in- and out-of-state Reduce or eliminate transcription costs Lower chronic disease management costs Lower wellness program costs Lower medication costs Increase charge capture with more complete documentation of the care provided

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1)Vendor Analysis Interface capabilities of the software Functions of the software o E-Prescribing o Remote/Mobile Needs o Security o Data exchange and interoperability o Computerized physician order entry (CPOE) Price 2) Budget/Financial Considerations 3) Penalty Assessment 4) Organizational readiness/provider buy-in Before Implementation: Deciding to Participate o Direct Secure Messaging/HIE o Patient Portal/Personal Health Records o Quality reporting o Coding standards Protecting and promoting the health and safety of the people of Wisconsin 13

1) County co-op or local health system partnership/sponsorship 2) Group purchases 3) Hospital donations 4) Bank loans and lines of credit 5) Credit Cards 6) Vendor financing options 7) Grants 8) Lab Companies 9) Malpractice Insurance Company Incentives Purchasing and Financing Options. Protecting and promoting the health and safety of the people of Wisconsin 14

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Steps to begin participating in the Wisconsin Medicaid EHR Incentive Program 16 Protecting and promoting the health and safety of the people of Wisconsin

▶ Upcoming Key Dates for the Current Program Year ∘ Program Year 2013 ends on December 31, 2013 ∘ The last day for Eligible Professionals to submit an application for Program Year 2013 is March 31, 2014 −Adopt, Implement, Upgrade: Eligible Professionals must demonstrate they Adopted, Implemented, or Upgraded their Certified EHR Technology (CEHRT) prior to December 31, 2013 −Meaningful Use: For those attesting to Meaningful Use, the EHR Reporting Period must be between January 1, 2013 and December 31, 2013  If this is the Eligible Professional’s first year attesting to Meaningful Use, the professional meets the requirements through the use of a consecutive 90-day EHR Reporting Period  The last day to start the 90-day EHR Reporting Period is October 2, Protecting and promoting the health and safety of the people of Wisconsin Important Dates for Eligible Professionals

EHR Incentive Program Information  CMS Medicare and Medicaid EHR Incentive Program Information ◦  Certified Health Information Technology List website ◦  Wisconsin Medicaid EHR Incentive Program Information ◦ ◦  Provider Services (HP) ◦ , ext , ext. 6 Technical Assistance  Wisconsin HIT Regional Extension Center (WHITEC) ◦ Statewide Health Information Exchange  Wisconsin Statewide Health Information Network (WISHIN), Inc. ◦ Resources Protecting and promoting the health and safety of the people of Wisconsin 18

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